Ureteroscopic lithotripsy with holmium laser for ureteral stones(Report of 350 cases)

Objective:Evaluate the safety and effectiveness of ureteroscopic lithotripsy with holmium laser for ureteral stones.Method:A total of 350 cases of ureteral stones,including stones and polyps in 35 cases,was treated by using ureteroscopic lithotripsy with holmium laser.Stone size was 0.6 to 2.0 cm(mean 1.2 cm).The ureteroscopy was placed under direct vision transurethrally.After finding the ureteral stone,600μm laser conduction fiber was placed against the stones,and the lithotripsy was manipulate with holmium laser by setting-up of 0.8-1.2 J/8-12 HZ power.For the cases of stone with polyps,fluid infusion rate was controlled after the ureteroscopy up to the ureteral polyps,which was alwasys below the stones.The holmium laser fiber was then placed in and polyps was gasification resected by holmium laser with 1.0-1.5 J/6-10 HZ power,and finally the stones were revealed for lithotripsy.Result:Of 350 cases of ureteral calculi,the success rate of one-stage stone clearance was 94%(329/350),and the one-stage clearance rate of ureteral polyp was 100%.The operation time was 20-60 min,with an average of 45min.The postoperative hospital stay was 2-5 days,with an average of three days.For 21 cases of upper ureteral calculi,some residual stone fragments driftted back into the pelvis in the process of lithotripsy,and these residual stones were treated with ESWL postoperatively.In the one to two months' follow-up,B ultrasonography and KUB were reviewed,and found that stones have been drained.There were no ureteral perforation of the mucosa,mucosal avulsion,fever and other complications.Conclusion:The ureteroscopic lithotripsy with holmium laser for ureteral stones was safe and efficient.It could also achieve a satisfactory therapeutic effect in the cases of stones and polyps.It was one of the best clinical treatment of the ureteral calculi.